[Extrauterine pregnancy: diagnosis and treatment]

The incidence of ectopic pregnancy in Denmark has doubled since the beginning of the 1980's. A total of 2400 cases per year are identified corresponding to an ectopic localization in one of 40 pregnancies. An early diagnosis of ectopic pregnancy depends on the use of vaginal ultrasound examination and serial determination of the concentration of serum-HCG. By this information the diagnosis of an ectopic pregnancy can usually be established without the use of laparoscopy. In approximately 20% of the women the ectopic pregnancy regresses without treatment. Laparoscopic salpingotomy compared to treatment by laparotomy reduces the hospital stay and the convalescence period. The fertility is preserved in 60-80% of the women, if the contralateral salpinx has not previously been damaged. The possibility of making the diagnosis of ectopic pregnancy without laparoscopy has resulted in an increased interest in medical treatment. Repeated administration of methotrexate leads to regression of the ectopic pregnancy in approximately 95% of the treated women, however, 20% have temporary unpleasant side-effects. After treatment with a single dose of methotrexate, the side effects are avoided. The effectiveness, however, seems severely reduced. There is a need for a continued development of non-invasive methods for the treatment of ectopic pregnancy.